Clinical characteristics and prognosis of patients with resistant hypertension and coronary artery disease

ZHANG Yan; LI Wei; GAO Linggen

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Medical Journal of the Chinese People Armed Police Forces ›› 2017, Vol. 28 ›› Issue (12) : 1205-1208.

ORIGINAL ARTICLES

Clinical characteristics and prognosis of patients with resistant hypertension and coronary artery disease

ZHANG Yan¹, LI Wei¹, GAO Linggen²

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Abstract

Objective To explore the clinical characteristics and prognosis of patients with resistant hypertension and coronary artery disease.Methods We evaluated 1030 patients with coronary artery disease. According to the currently accepted definition of resistant hypertension, the secondary causes of resistant hypertension were excluded. The primary outcome was major cardiovascular events, including fatal coronary heart disease, nonfatal myocardial infarction and stroke.Results Among the 1030 patients in this study, 88 (8.5%) had apparent resistant hypertension. In a multivariable model adjusting for baseline differences, the resistant hypertension group had an increased primary outcome when compared with the no apparent resistant hypertension group. A multivariate analysis showed that older age, higher BMI, a history of diabetes and chronic heart failure were independent risk factors for resistant hypertension.Conclusions In patients with coronary artery disease, resistant hypertension is associated with a significant increase in the risk of cardiovascular morbidity and mortality. Clear diagnoses and effective treatment are of great importance.

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coronary artery disease / resistant hypertension / prognosis

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ZHANG Yan, LI Wei, GAO Linggen. Clinical characteristics and prognosis of patients with resistant hypertension and coronary artery disease[J]. Medical Journal of the Chinese People Armed Police Forces. 2017, 28(12): 1205-1208

References

[1] 陈伟伟,高润霖,刘力生,等.《中国心血管病报告2014》概要 [J].中国循环杂志, 2015,30(7):617-622.
[2] 中国高血压防治指南修订委员会.中国高血压防治指南2010 [J].中华心血管病杂志,2011,39(7):579-616.
[3] Egan B M, Zhao Y, Axon R N, et al. Uncontrolled and apparent treatment resistant hypertension in the United States, 1988 to 2008 [J]. Circulation,2011,124(9):1046-1058.
[4] Daugherty S L, Powers J D, Magid D J, et al. Incidence and prognosis of resistant hypertension in hypertensive patients[J]. Circulation,2012,125(13):1635-1642.
[5] Persell S D. Prevalence of resistant hypertension in the United States, 2003-2008[J]. Hypertension,2011, 57(6):1076-1080.
[6] 孙宁玲,霍勇,王继光,等.难治性高血压诊断治疗中国专家共识 [J].中国介入心脏病学杂志,2013,21(2):69-74.
[7] Schmieder R E,Redon J,Grassi G,et al. ESH position paper: renal denervation-an interventional therapy of resistant hypertension [J]. J Hypertens, 2012,30(5):837-841.
[8] Bakris G L, Townsend R R, Liu M, et al. Impact of renal denervation on 24-hour ambulatory blood pressure:results from symplicity HTN-3 [J]. J Am Coll Cardiol,2014,64(11): 1071-1078.
[9] Rossi G P, Seccia T M, Maniero C. Drug-related hypertension and resistance to antihypertensive treatment: a call for action [J]. J Hypertens, 2011, 29(12):2295-2309.
[10] Williams B, MacDonald T M, Morant S, et al. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2):a randomised, double-blind, crossover trial[J].Lancet,2015,386(10008):2059-2068.
[11] Sternlicht H, Bakris G L. Spironolactone for resistant hypertension--hard to resist? [J].Lancet, 2015, 386(10008):2032-2034.
[12] 牟建军,何明俊.难治性高血压诊断治疗现状[J].中华高血压杂志 2014,22(1);87-90.
[13] Cuspidi C, Macca G, Sampieri L, et al. High prevalence of cardiac andextracardiac target organ damage in refractory hypertension[J].J Hypertens, 2001,19(11):2063-2070.
[14] Kumbhani D J, Steg P G, Cannon C P, et al. Resistant hypertension: afrequent and ominous finding among hypertensive patients with atherothrombosis[J]. Eur Heart J, 2012, 34(16):1204-1214.
[15] Krum H,Schlaich M,Whitbourn R,et al. Catheter-based renal sympathetic denervation for resistant hypertension:a multicentre safety and proof -of-principle cohort study [J].Lancet, 2009, 373(9671): 1275-1281.
[16] Esler M D, Krum H, Schlaich M, et al. Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the symplicity HTN-2randomized, controlled trial [J] . Circulation, 2012,126(25): 2976-2982.
[17] Bhatt D L,Kandzari D E,O’Neill W W, et al. A controlled trial of renal denervation for resistant hypertension[J]. N Engl J Med, 2014, 370(15):1393-1401.
[18] Vink E E, Verloop W L, Bost R B,et al. The blood pressure-lowering effect of renal denervation is inversely related to kidney function[J].J Hypertens, 2014,32(10):2045-2053.
[19] Persu A, Jin Y, Azizi M, et al. Blood pressure changes after renal denervation at 10 European expert centers [J] .J Hum Hypertens,2014, 28(3):150-156.